Cochrane in context: Combined and alternating paracetamol and ibuprofen therapy for febrile children

Wong, Tiffany; Stang, Antonia; Ganshorn, Heather; Hartling, Lisa; Maconochie, Ian; Thomsen, Anna M; Johnson, David W.

doi:10.1002/ebch.1979

Cited by 23 publications

(16 citation statements)

References 2 publications

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“…Because acetaminophen and ibuprofen act as COX-enzyme inhibitors on a central respectively a peripheral level they maximally inhibit PGE2 synthesis produced by exercise-induced IL-6 release. Whilst COX has been shown to not affect forearm sweating 28 , a clinical study suggested that the combined therapy of acetaminophen and ibuprofen is more effective in lowering TC during fever 29 . The present study expands this observation to an exercise setting.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Central and Peripheral Cyclooxygenase Enzyme Inhibition on Exercise-Induced Elevations in Core Body Temperature

Veltmeijer¹,

Veeneman²,

Bongers³

et al. 2017

International Journal of Sports Physiology and Performance

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Section: Discussionmentioning

confidence: 99%

The Impact of Central and Peripheral Cyclooxygenase Enzyme Inhibition on Exercise-Induced Elevations in Core Body Temperature

Veltmeijer¹,

Veeneman²,

Bongers³

et al. 2017

International Journal of Sports Physiology and Performance

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“…Although associations can obviously show additive or even synergistic effects, currently the combination of paracetamol and ibuprofen, whether given alternately or together, is not recommended for the treatment of fever [18]. There is insufficient evidence to state that combined/alternating treatment in febrile states can be of more benefit, considering that the clinical efficacy of 15 mg/kg paracetamol monotherapy currently enables excellent management of the symptom.…”

Section: Introductionmentioning

confidence: 99%

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Martino

Chiarugi

Boner

et al. 2017

Drugs

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Ibuprofen is the most widely used non-steroidal anti-inflammatory drug (NSAID) for the treatment of inflammation, mild-to-moderate pain and fever in children, and is the only NSAID approved for use in children aged ≥3 months. Its efficacy and safety profile have led to its increasing use in paediatric care, even without medical prescription. However, an increase of suspected adverse reactions to ibuprofen has been noted in concomitance with the raised, often medically unsupervised, consumption of the drug. The purpose of this work was a critical review of the paediatric literature over the last 15 years on side effects and adverse events associated with ibuprofen, in order to highlight circumstances associated with higher risks and to promote safe and appropriate use of this drug. The literature from 2000 to date demonstrates that gastrointestinal events are rare, but (when they occur) include both upper and lower digestive tract lesions. Dehydration plays an important role in triggering renal damage, so ibuprofen should not be given to patients with diarrhoea and vomiting, with or without fever. Likewise, ibuprofen should never be administered to patients who are sensitive to it or to other NSAIDs. It is contraindicated in neonates and in children with wheezing and persistent asthma and/or during varicella. Most of the analysed studies reported adverse events when ibuprofen was being used for fever symptoms or flu-like syndrome. Ibuprofen should not be used as an antipyretic, except in rare cases. Ibuprofen remains the drug of first choice in the treatment of inflammatory pain in children.

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“…Regarding use of medications to treat fever, antipyretics such as paracetamol and Ibuprofen were used. Health professionals frequently recommend treatment regimens for children with fever that either combine or alternate paracetamol and ibuprofen [23,24]. However, the consequences of under-and over-treatment with antipyretics including mucosal lesions, gastrointestinal discomfort such as dyspepsia, and severe gastrointestinal complications such as perforated ulcer, gastrointestinal bleeding has been reported [25].…”

Section: Resultsmentioning

confidence: 99%

Childhood Fever Knowledge and Management: A Case of Mothers with Children under Five Years

Anokye¹,

Rita²,

Patience³

et al. 2018

Int J Pediatr Res

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Background: Most childhood ailments often present with fever which account for the most common reasons why parents seek medical care for their children; particularly, the under-five children. The study aimed to assess the mothers' knowledge of fever in their under-five children and how this is managed at home. Methods: This was a descriptive designed study that used a simple random sampling technique to select 100 participants who were mothers of under-five children who presented to the Kwahu Government Hospital, Atibie over a period of six months. A structured questionnaire comprising of close-ended questions were used to collect data. Both secondary and primary data were collected and analyzed. The primary data was analyzed using SPSS version 16.0. Results: The mothers described fever as hotness of body (63%), shivering (10%), child crying (8%), child being quiet (8%) and sleeping too often (10%). More than half of the respondents (57%) correctly identified the cause of fever as malaria (39%) and infections (18%). Home management of fever involved self-medications (43%), consulting herbalist (20%) as well as tepid sponging (28%) and visiting nearby hospital (62%). Mothers knowledge of childhood fever was statistically significantly associated with their age (p = 0.0001), age of the child (p = 0.04), number of children in a family (p = 0.0001), and level of education of the mothers (p = 0.0001). Conclusions: Mothers described hotness of the body as fever and knew that malaria and infections causes fever among children. They consulted herbalist among other inappropriate practices in the management of fever.

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Cochrane in context: Combined and alternating paracetamol and ibuprofen therapy for febrile children

Cited by 23 publications

References 2 publications

The Impact of Central and Peripheral Cyclooxygenase Enzyme Inhibition on Exercise-Induced Elevations in Core Body Temperature

The Impact of Central and Peripheral Cyclooxygenase Enzyme Inhibition on Exercise-Induced Elevations in Core Body Temperature

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Childhood Fever Knowledge and Management: A Case of Mothers with Children under Five Years

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